Organization
LIFESTYLE MEDICINE ,LLC
Active
Other names
Lifestyle Medicine ,LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE ROBERSON (CONSULTANT)
(337) 519-6304
Entity
Organization
Contact information
Practice address
2309 OLD JEANERETTE RD, NEW IBERIA, LA 70563-3040
(337) 256-5317
Mailing address
2309 OLD JEANERETTE RD, NEW IBERIA, LA 70563-3040
(337) 256-5317
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
02/01/2021
Last updated
02/22/2021
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